Now that the door is open: an update on ischemic stroke pharmacotherapeutics for the neurointerventionalist

J Neurointerv Surg. 2024 Mar 14;16(4):425-428. doi: 10.1136/jnis-2022-019293.

Abstract

The last 10 years have seen a major shift in management of large vessel ischemic stroke with changes towards ever-expanding use of reperfusion therapies (intravenous thrombolysis and mechanical thrombectomy). These strategies 'open the door' to acute therapeutics for ischemic tissue, and we should investigate novel therapeutic approaches to enhance survival of recently reperfused brain. Key insights into new approaches have been provided through translational research models and preclinical paradigms, and through detailed research on ischemic mechanisms. Additional recent clinical trials offer exciting salvos into this new strategy of pairing reperfusion with neuroprotective therapy. This pairing strategy can be employed using drugs that have shown neuroprotective efficacy; neurointerventionalists can administer these during or immediately after reperfusion therapy. This represents a crucial moment when we emphasize reperfusion, and have the technological capability along with the clinical trial experience to lead the way in multiprong approaches to stroke treatment.

Keywords: Drug; Pharmacology; Stroke; Thrombectomy.

Publication types

  • Review

MeSH terms

  • Brain Ischemia* / drug therapy
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Ischemic Stroke* / drug therapy
  • Stroke* / drug therapy
  • Thrombectomy
  • Thrombolytic Therapy
  • Treatment Outcome

Substances

  • Fibrinolytic Agents